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Writing about our ObamaCare experiences with the future of the program so much in doubt seems almost pointless, but I did promise to keep honestly updating you so here’s the latest.

Learning that Blue Cross was pulling out of the Marketplace in our area was really scary.  We were used to everything about the plan after three years and were happy with it.  I wasn’t looking forward to getting onto the (terrible, still) Healthcare.gov site and having to compare all the plans like I had to do when we first signed up.

Turns out I didn’t have to worry about that, because when I finally got through the approximately three hours over three days of attempts and two phone calls it took me to update my application (yes, really), I had one choice and one choice only.

We have Humana now and before I get into the nitty gritty of the pros and cons of that, can I just mention that Humana announced that they too will be pulling out of the Marketplace in 2018?  Which will leave us . . . where?  I don’t even exactly know.  If someone else were in charge of the country I’d be confident it would be fixed by then.  As it is . . . well, I am not going to worry about it yet because what’s the point.

So here’s the good, the bad, and the ugly update:

I guess the ugly would be that even though Jake is under 26 and should be eligible to be covered by our insurance, and even though we’ve been allowed to include a non-dependent child of the proper age in the past, the system flat out refused to let me sign up with him included.  And the nice person on the phone said it was because he isn’t a dependent for tax purposes, but right there ON THE WEBSITE INSTRUCTIONS it said he was still eligible.  But none of us were going to get covered if I didn’t take him off.  So then I tried to apply for him on his own, but because our governor in his “wisdom” declined the Medicaid expansion (which is also why we are losing insurers), Jake’s one of the unlucky who fall into the hole between being eligible for Medicaid and qualifying for a subsidy, which makes no sense, but whatever.  So what that means is that he cannot afford to pay for the high deductible catastrophic plan he was offered, and is currently uninsured until he has another opportunity to sign up at work (which he didn’t do at the proper time BECAUSE WE WERE COVERING HIM).  Hopefully he will qualify for one of the many exceptions to the mandate and won’t have to pay a fine come next year’s tax time.

And now for the bad:  Our deductible had been ridiculously low–$300 per person, $600 per family.  We were able to knock it out in a month or two mostly with prescriptions.  This year it’s $900/$1800.  I know that’s still way lower than many people so I shouldn’t complain too much.  The other bad thing is that some of our doctors–specifically, our mental health professionals–are out of network.  And since we are not going to change psychologists, we will be paying out of pocket for that.  Happily, our provider is working with us and charging what insurance would pay him if we had it; but that’s still $45 more a week than we were paying before.  Finally, Walgreens doesn’t take Humana, if you can believe it.  The closest pharmacy that does is Food City.  So I had to transfer about a million (give or take) prescriptions, and will have to actually WALK INSIDE to get our medicines, and do so before 7 p.m.

But there is also some good, some of it actually very good.  Our premium dropped by $450.  We are paying $241 a month! (By the way, this is for four people, as William and Lorelei are still on TennCare even though we have tried to sign them up with the rest of us.)  And there is no deductible for prescriptions–they are covered immediately.  They might be slightly more expensive but I got thirteen medications for about $65 so I’m calling that a good deal.  Of course that means they won’t apply to the deductible so it’s going to take longer to meet it, but all and all I wouldn’t be surprised if our overall costs end up being lower this year.

So there you have it.  We shall enjoy it while we can and I will update you if anything interesting happens. 🙂

P.S.  When anyone calls ObamaCare a failure, direct them here.  It has problems, it needs fixing, but it has helped us and many others.  It needs to be REPAIRED, not REPEALED.

For more of my ObamaCare stories, see below and click away!

The $64,000 Question, Answered

Who Are the Uninsured?

Uninsured No More

ObamaCare Update

ObamaCare Update 2

ObamaCare:  My Latest Update

ObamaCare Revisited

More on Our Journey to Health, Brought to You by Obamacare

It’s Good to Be Insured: An ObamaCare Update

Obamacare in Practice:  An Update

An Open Letter to My Friends Who Want to Repeal ObamaCare

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I know I just updated recently but I have some things I really wanted to post about and I don’t feel like waiting!

Let’s start with the not-so-good parts, because while want people to see the enormous good in our Obamacare experience I lose credibility if I insist this new health care system is perfect.

I already told you that four out of seven of us were approved for subsidies and enrolled in a plan, while the other three were inexplicably deemed ineligible. And when I say inexplicable, I mean not only can I not understand it, neither can any of the Healthcare.gov customer service people I’ve spoken to. Anyway, I appealed this decision, through a formal process that involved submitting all sorts of paperwork. I think I had 30 days to do that, which means I probably did it in February some time. A couple of months ago I got a phone call about my appeal, and then last week I got a letter saying to expect a call at a certain date and time, and to be prepared with the information they wanted. Well, the day came and I waited and waited and they never called me. I called the next day and spoke to a very nice and very confused woman who finally figured out that they called Teddy instead of me even though it said RIGHT IN THE LETTER that they would be calling my number. So she fixed the number and said the next thing that will happen is that I will get a letter setting a formal telephone hearing. So we’ll see.

In the meantime, the Marketplace wrote me and they want MORE financial information, which is the second time since I applied that they’ve asked for more information, and I they want check stubs for everyone in the house who works, which is kind of difficult since two of us are self-employed. So there is no denying that it’s the government, and a bureaucracy, and that I (or you) could run it better. (Not that private insurance companies are any better, and that’s a moot point anyway for the many Americans who are uninsurable or can’t afford insurance–so you take the bad with the good.)

But on the bright side . . . Last week I went into the doctor’s office for a fasting blood draw, in preparation for yesterday’s checkup, which my doctor set for three months out from the last one. When I walked in she told me that basically I had reversed every single problem I arrived with. 🙂 She was so impressed that she gave me a hug! My blood pressure has gone down to borderline, my cholesterol is just two points shy of normal, my blood sugar dropped nine points, and my triglycerides dropped over 100 points. And . . . I’ve lost 27 pounds, without being on any official regimented diet, and WITHOUT BEING HUNGRY.

Now, some people might say that Obamacare doesn’t deserve the credit for this, but let me tell you a story. Six years ago I had my last checkup and got blood work done. At that time all of the above factors were close to what they are now, so above where they should be but not yet dangerously so. But because I did not have insurance, that one appointment was all I got. No one offered me any suggestions. They said, “We’ll keep an eye on it,” but how could they when I couldn’t afford regular checkups and blood work? This time, I’ve seen my doctor three times, the wellness nurse three times, and the nutritionist once. The nutritionist will continue to monitor me and do bloodwork every three months to track my progress. Moreover, they gave me the suggestions and the support I needed to succeed. This is what preventive medicine is all about. Without it, people bumble along and get fatter and sicker and end up in emergency rooms having heart attacks, or going on disability, costing ALL of us money (not to mention the cost in human misery, which is far more important to me). This kind of care makes sense and I am so grateful to be benefiting from it.

Me, Happy to Be Insured and Getting Healthy

Me, Happy to Be Insured and Getting Healthy

For more on our journey from being uninsured to becoming healthy, and on my views on Obamacare in general, see the links below.

The $64,000 Question, Answered

Who Are the Uninsured?

Uninsured No More

ObamaCare Update

ObamaCare Update 2

ObamaCare:  My Latest Update

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